基于胜任力模型的人力资源绩效管理体系研究

对上海市浦东新区卫生监督执法人员开展岗位胜任力测评,探索岗位胜任力与绩效水平之间的关系,为提升浦东新区卫生监督执法人员综合素质及绩效管理水平提供参考。

运用关键行为事件访谈法对7名卫生监督执法人员进行访谈,结合专家咨询结果,建立浦东新区卫生监督执法人员胜任力模型及相应岗位胜任力测评指标体系。通过问卷调查,对浦东新区卫生监督执法人员岗位胜任力情况、绩效水平进行评价,运用多元线性回归分析,研究胜任力与绩效之间的关系。

浦东新区卫生监督执法人员在监督执法专业技能上具有一定优势,依法监督、依法行政能得到有效落实,但是科研能力略显不足。通过差异性分析得出：年龄越大,知识储备越多,工作>15年的监督员在知识储备上水平最高;男性监督员的现场监督执法能力略高于女性;中级职称的监督员在知识储备、科研创新能力、个人特质上的胜任力均为最高;部门负责人在科研创新上的胜任力均值都高于一般科员;专业科室的科研创新能力高于执法中队。从回归系数来看,现场监督执法能力对绩效具有显著的正向影响（P<0.05）,影响系数为0.385。

基于胜任特征模型的岗位胜任力测评指标体系,在一定程度上能够反映出卫生监督员的实际岗位胜任情况,提升卫生监督执法人员的绩效水平可着重从提高监督员的现场监督执法能力上入手。

     

Impact of long-term home care on hospital and nursing home use and cost.

This article reports the long-range impact of a long-term home care program in Chicago on hospital and nursing home use and on overall health care costs over four client-years of observation. The evaluation utilized a quasi-experimental design with a comparison group composed of clients who received home-delivered meals. The health services utilization experience of consecutively accepted treatment (N = 157) and comparison group (N = 156) subjects was monitored for 48 client-months following acceptance to care. Imputed costs were then assigned to each type of care measured. Findings include a significantly lower risk of permanent admission to sheltered and intermediate-level nursing home care in the treatment group but no difference in risk of permanent admission to skilled-level nursing home care. Despite savings in low-intensity nursing home days, preliminary findings indicate that total costs of care were 25 percent higher in the treatment group. However, these costs are accompanied by significant quality-of-life benefits in the treatment group (reported elsewhere).     

Current marketing practices in the nursing home sector

Marketing is widely recognized as an essential business function across all industries, including healthcare. While many long-term care facilities adopted basic healthcare marketing practices and hired marketing staff by the early 1990s, a paucity of research on nursing home marketing exists in the literature. This study examines the extent to which nursing homes have developed more formulated marketing and related communication and promotional strategies as market competition has increased in this sector during the past two decades. In addition, we explored managers' perceptions of their control over marketing decision making, the impact of competition on the use of marketing practices, and areas for enhanced competitive positioning. Administrators from 230 nursing homes in 18 Southeastern Michigan counties were surveyed regarding (1) the adoption level of approximately 40 literature-based, best-practice marketing strategies; (2) the types of staff involved with the marketing function; and (3) their perception of their level of control over marketing functions and of local competition. Results from 101 (44 percent) survey participants revealed that although respondents viewed their markets as highly competitive, their marketing practices remained focused on traditional and relatively constrained practices. In relation to the importance of customer relationship management, the majority of the administrators reported intensive efforts being focused on residents and their families, referrers, and staff, with minimal efforts being extended to insurers and other types of payers. A significant positive relation was found between the intensity of marketing initiatives and the size of the facility (number of beds), whereas significant negative correlations were revealed in relation to occupancy and the perceived level of control over the function.     

Ownership conversions and nursing home performance

Objective. To examine the effects of ownership conversions on nursing home performance.
Data Source. Online Survey, Certification, and Reporting system data from 1993 to 2004, and the Minimum Data Set (MDS) facility reports from 1998 to 2004.
Study Design. Regression specification incorporating facility fixed effects, with terms to identify trends in the pre- and postconversion periods.
Principal Findings. The annual rate of nursing home conversions almost tripled between 1994 and 2004. Our regression results indicate converting facilities are generally different throughout the pre/postconversion years, suggesting little causal effect of ownership conversions on nursing home performance. Before and after conversion, nursing homes converting from nonprofit to for-profit status generally exhibit deterioration in their performance, while nursing homes converting from for-profit to nonprofit status generally exhibit improvement.
Conclusions. Policy makers have expressed concern regarding the implications of ownership conversions for nursing home performance. Our results imply that regulators and policy makers should not only monitor the outcomes of nursing home conversions, but also the targets of these conversions.     

发展型人力资源管理实践对公立医院医务人员创新绩效的影响及中介效应

目的：分析发展型人力资源管理实践对公立医院医务人员创新绩效的影响,以及心理授权和组织认同在其中的中介作用。方法：基于发展型人力资源管理实践量表、创新绩效量表、心理授权量表和组织认同量表对北京市公立医院1 898名医务人员开展问卷调查。利用Amos 23.0软件构建结构方程模型进行中介效应检验。结果：北京市公立医院医务人员的发展型人力资源管理实践、心理授权、组织认同和创新绩效两两之间呈显著正相关;发展型人力资源管理实践会影响创新绩效,总效应为0.605,其中直接效应值为0.205,占总效应的33.88%。同时存在一条间接影响路径,即心理授权的独立中介作用,其中介效应值为0.377;而组织认同的中介效应不显著。结论：发展型人力资源管理实践会直接或间接地通过心理授权影响公立医院医务人员的创新绩效,提示公立医院管理者在提高创新绩效时要尤为重视发展型人力资源管理的作用,并且需特别注意提高医务人员的心理授权。     

科研院所人力资源管理思考

人力资源管理是管理学中的一个重要领域。它作为对一种特殊的经济性和社会性资源进行管理而存在。人力资源管理是指组织对员工进行有效管理和使用的思想和行为。它远远超出了传统的人事管理范畴。正因如此，构建以人为本、和谐型并具有主动性的人力资源管理，越来越受到重视。     

卫生人力资源管理信息化建设之我见

21世纪信息化步伐的迅速加快,对经济、社会与文化生活带来前所未有的影响,也给人力资源管理带来了更多挑战.文章根据卫生人力资源管理的要求以及信息化管理的必要性,结合分析当前卫生人力资源管理信息化建设存在的问题,提出了进一步加强人力资源管理信息化的策略措施.     

Linking nursing home working conditions to organizational performance

Exploring selected working conditions and performance in nursing homes suggests that high and low performers can be determined based on both quantitative and qualitative findings.     

护理薪酬绩效分配的管理

为了调动护理人员的工作积极性，达到护理薪酬绩效分配的和谐管理环境，诸暨市人民医院自2001年始对全院临床护理人员实行护理薪酬绩效分配管理。经6年的不断改革完善运行，医院护理人力资源管理获得了较好的效果，对医院护理工作的发展起到了积极的作用。     

Determinants of performance failure in the nursing home industry

This study investigates the determinants of performance failure in U.S. nursing homes. The sample consisted of 91,168 surveys from 10,901 facilities included in the Online Survey Certification and Reporting system from 1996 to 2005. Failed performance was defined as termination from the Medicare and Medicaid programs. Determinants of performance failure were identified as core structural change (ownership change), peripheral change (related diversification), prior financial and quality of care performance, size and environmental shock (Medicaid case mix reimbursement and prospective payment system introduction). Additional control variables that could contribute to the likelihood of performance failure were included in a cross-sectional time series generalized estimating equation logistic regression model. Our results support the contention, derived from structural inertia theory, that where in an organization's structure change occurs determines whether it is adaptive or disruptive. In addition, while poor prior financial and quality performance and the introduction of case mix reimbursement increases the risk of failure, larger size is protective, decreasing the likelihood of performance failure.     

Impact of physician telephone management of nursing home residents before the initial assessment: a pilot study

OBJECTIVE: To describe physician telephone management of newly admitted nursing home residents before direct evaluation by the physician, and the effect on resident outcomes. DESIGN: Retrospective chart review of 111 consecutive discharge records from two proprietary community nursing homes in Baltimore, Maryland in 1999. MEASUREMENTS: Data regarding the admission process were collected, with an emphasis on physician telephone orders at admission and all subsequent telephone orders before the first physician visit. Physicians were categorized as attending physicians or on-call physicians. Unexpected outcomes defined as an unplanned admission to an acute hospital or an unanticipated death within 14 days of admission to the nursing home were identified. The relationships among resident, physician, and admission characteristics and unexpected outcomes were analyzed. RESULTS: Most residents (97 of 111 (87%)) were admitted from an acute hospital, and the remaining 13% were admitted from home or another nursing home. An attending physician confirmed admission orders for 87 of 111 (78%) residents, and an on-call physician confirmed admission orders for the remainder. Physicians changed medications at the time of admission, as compared with preadmission medications, in 58 of 111 (52%) residents and ordered laboratory studies or radiographs in 59 of 111 (53%). On-call physicians were just as likely to make both types of changes as attending physicians. In the time interval after the initial telephone contact but before the first physician visit, medication changes were made in 35 of 111 (32%) residents and testing was ordered in 16 of 111 (14%). Nineteen of 111 (17%) residents were either readmitted to the hospital or died within 14 days of admission to the nursing home. These unexpected outcomes were statistically less likely to occur in the group of residents for whom physicians made medication changes at the time of admission as compared to the group for whom no medication changes were made [6 of 58 (10%) versus 13 of 53 (25%), P = 0.04, respectively], and in the group for whom tests were ordered at the time of admission as compared to not ordered [4 of 59 (7%) versus 15 of 51 (29%), P = 0.002, respectively]. There were no differences in the likelihood of unexpected outcomes when physicians made medication changes or ordered tests after the time of admission but before the first physician visit. CONCLUSIONS: In this study, physicians made adjustments in medications and ordered tests for newly admitted nursing home patients before seeing the resident in the majority of cases. Unexpected outcomes including readmission to the hospital or death within 14 days of admission were less common among those residents when such changes were made at the time of admission. Further studies are needed to identify those changes as well as those resident and physician characteristics that might lead to improved outcomes.     

Impact of nursing home deaths on life expectancy calculations in small areas

STUDY OBJECTIVE: The drive to tackle health inequalities at the local level has increased interest in mortality data for small populations. There is some concern that nursing homes may affect measures of mortality for small populations, but there has been little in depth analysis of this. DESIGN AND SETTING: Deaths between 1997 and 2001 and population figures from the GP register (Exeter) database and census 2001 were used to produce life expectancy (LE) figures for all electoral wards in West Sussex. The proportion of those dying within each ward that had been residents of nursing homes was calculated and the relation between these variables and deprivation investigated. RESULTS: There was a significant linear relation between nursing home deaths and LE (p<0.0001), which explained 36% of variation in LE between wards. Deprivation accounted for around 35% of the variation in LE (p<0.0001) but was not correlated with nursing home deaths (p> or =0.0982). Multiple linear regression shows that over 60% of the variation in LE at ward level can be explained by both nursing home deaths and deprivation (p<0.0001) and that the two variables explain similar proportions of this variation. The relation between LE and nursing home deaths within wards grouped by deprivation suggests that the impact of nursing homes is strongest in deprived wards. CONCLUSIONS: This finding has important implications for LE calculations in small populations. Further investigation is now needed to examine the impact of nursing homes in other areas, on other mortality measures, and in larger populations.     

西方人力资源管理理论对我国卫生人力资源管理的启示

该文首先对卫生人力资源管理的基本内容和主要职能进行了简要介绍,然后通过介绍西方人力资源管理的六项法则分析其对我国卫生人力资源管理的启示,旨在引起我国卫生管理部门或有关人员的重视,从而借鉴西方的理论和经验,探索我国卫生人力资源管理的方法和模式。     

人文管理在医院感染管理工作中的应用

目的探讨人文管理内涵、特征、意义和现状及在医院感染管理工作中的有效应用。方法把"人"作为医院管理活动的主体和最重要的资源,强调以人为本、以人为主体、满足人的需求,强化人的合作,以调动和激发人的积极性和创造性为根本手段,以达到提高效率和人的不断发展。结果提升医院感染管理工作水平,树立学科威信,调动和激发医护人员的积极性和参与性,从而提高医院感染管理工作的效能。结论使医院感染管理形成良性管理机制,促进医院整体目标的实现,达到双赢。     

卫生事业管理专业人力资源管理教学探讨

人力资源管理是卫生事业管理专业的一门重要课程,该文结合卫生事业管理专业的特点,分析目前人力资源管理教学中存在的问题,并从教学内容、教学方法、考核方式、师生交流、教材开发、师资队伍建设等方面提出改进对策,以提高教学效果,达到教学目标要求。     

军队医院护理人员排班研究

目的为探讨刍：队医院护理人力资源的利用现状，合理配置现有护理人力资源，使工作效率达到最大化。方法借助卫生经济学、卫生经济管理学及现代护理管理学的有关理论，采用了对部分医院临床科的军人护士和聘用护士进行问卷调查的方式。结果不同等级的医院、不同的科室工作量和工作效率并不完全相同，忙闲不均，各级护理人员在多数操作项目中没有层次差别，因而人力资源的能级浪费与不适宜服务并存。结论对护理人员的班次进行合理编排，形成最佳的能力结构和职称结构，真正实现以病人为中心的整体护理。